Wei Chunxiao, Zhao Panpan, Zhai Weijie, Zhao Meng, Sun Li
Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China.
Mol Neurobiol. 2025 Jun 13. doi: 10.1007/s12035-025-05142-7.
Disruption of iron homeostasis is associated with the pathogenesis of neurological disorders. This study aims to elucidate the correlation between serum iron metabolism profiles and the occurrence of post-stroke cognitive impairment (PSCI). Acute ischemic stroke (AIS) patients (n = 500) were enrolled, and serum iron metabolism parameters were collected at baseline. Cognitive abilities, including global cognition, episodic memory, language proficiency, attention, and executive function, were successfully assessed in participants six months after the AIS event (n = 224, mean age = 62). Multivariate logistic regression analysis was employed to screen for iron metabolism indicators influencing PSCI. A general linear model was used to analyze the correlation between total iron-binding capacity (TIBC) and overall cognitive function as well as performance in various cognitive domains. Additionally, we constructed a nomogram model to predict PSCI risk and validated its performance. The results revealed that the TIBC levels were significantly lower in the PSCI group. Elevated TIBC levels may represent a potential protective factor against PSCI development (OR = 0.940, 95% CI = 0.894-0.989, p = 0.018). Furthermore, higher serum TIBC levels were associated with better overall cognitive function, episodic memory, and language proficiency. The nomogram model constructed using age, gender, education level, National Institutes of Health Stroke Scale (NIHSS) score, and TIBC variables demonstrated good predictive performance for PSCI risk (AUC = 0.761, 95%CI = 0.696-0.825). In conclusion, serum TIBC is a potential biomarker for PSCI and is closely associated with cognitive ability.
铁稳态的破坏与神经系统疾病的发病机制相关。本研究旨在阐明血清铁代谢谱与中风后认知障碍（PSCI）发生之间的相关性。纳入急性缺血性中风（AIS）患者（n = 500），并在基线时收集血清铁代谢参数。在AIS事件发生六个月后，成功评估了参与者的认知能力，包括整体认知、情景记忆、语言能力、注意力和执行功能（n = 224，平均年龄 = 62岁）。采用多因素逻辑回归分析筛选影响PSCI的铁代谢指标。使用一般线性模型分析总铁结合力（TIBC）与整体认知功能以及各个认知领域表现之间的相关性。此外，我们构建了一个列线图模型来预测PSCI风险并验证其性能。结果显示，PSCI组的TIBC水平显著较低。TIBC水平升高可能是预防PSCI发展的潜在保护因素（OR = 0.940，95%CI = 0.894 - 0.989，p = 0.018）。此外，较高的血清TIBC水平与较好的整体认知功能、情景记忆和语言能力相关。使用年龄、性别、教育水平、美国国立卫生研究院卒中量表（NIHSS）评分和TIBC变量构建的列线图模型对PSCI风险具有良好的预测性能（AUC = 0.761，95%CI = 0.696 - 0.825）。总之，血清TIBC是PSCI的潜在生物标志物，且与认知能力密切相关。
